Pa. abortion trial: Assistant gave anesthesia

PHILADELPHIA (AP) — A woman trained only as a medical assistant told jurors Wednesday that she gave anesthesia, set dosing amounts and performed ultrasounds when she worked at a now-shuttered abortion clinic whose owner is on trial in the death of a female patient and seven babies allegedly born alive.

Latosha Lewis is among the final prosecution witnesses at the five-week murder trial of Dr. Kermit Gosnell, 72. She caps a string of former employees who have testified that they went to work at the chaotic, rundown clinic because they were desperate for work, or were former patients, or knew Gosnell through his family or the gritty West Philadelphia neighborhood.

They have all pleaded guilty to criminal charges in the case and face years in prison for third-degree murder, conspiracy, racketeering, drug distribution or other charges.

Investigators say Gosnell ran a "pill mill" by day frequented by addicts and drug dealers; and an illegal "abortion mill" by night, where poor women with late-term pregnancies endured long, painful procedures performed by untrained staff until Gosnell arrived late for the final phase of the surgical abortions.

Lewis, 31, testified that she had gone to a career school for eight months to qualify as a medical assistant, and was sent to Gosnell's clinic as part of training. Before long, she was hired to do paperwork and draw blood.

But that quickly morphed into skilled work as she, like her co-workers, delivered intravenous drugs, performed ultrasounds and made independent decisions about how much anesthesia patients should get. At one point, she had a scare with a patient.

"I had given her too much (medication) and I was concerned whether or not she would come (back) from anesthesia," Lewis testified.

Women often got near-hourly doses of Cytotec, a drug designed to induce labor, as they waited for Gosnell to arrive, along with painkillers to quell the powerful cramping, Lewis said. She sometimes chose to reduce the dosages.

By 2008, Lewis had moved from the procedure area to the front desk because she was no longer comfortable with the amount of drugs the patients were given.

"The women were going into labor too fast, and I didn't want to deal with it," Lewis testified, adding that she still handed out some medications.

The patient who died, 41-year-old refugee Karnamaya Mongar, was given four doses of Cytotec during her November 2009 visit, along with the out-of-fashion painkiller Demerol and other drugs, according to notes scrawled randomly across her medical paperwork. Investigators say she died of an overdose.

Mongar, who had spent 20 years in a refugee camp before arriving in the U.S. months before her death, was 4-foot-11 and did not speak English. Lewis said she went over the consent form with her daughter — who testified this week through a translator.

Lewis, who checked in Mongar when she arrived at the clinic from Virginia, said her chart does not list her weight because the clinic's scale was broken. It hadn't worked in a month, she said.

As many as two dozen women a day came in for abortions, some of whom delivered babies in toilets or waiting areas before Gosnell arrived, according to staff testimony. Gosnell had taught them to snip the babies in the back of the neck to "ensure fetal demise," according to the testimony of unlicensed doctor Stephen Massof and others.

Massof and two others have pleaded guilty to third-degree murder.

Defense lawyer Jack McMahon argues that there were no live births at the clinic, and that any movement seen by the staff was an involuntary response amid the death process. He has suggested that Mongar had unreported respiratory problems and died of unforeseen complications.